Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Surgical Results with Low-Grade Arteriovenous Malformations : A Single Center 14-Year Experience

  • Woo-Jun Hong (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Kang-Hee Ahn (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Yong-Jun Lee (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Woong-Beom Kim (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • You-Sub Kim (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Tae-Sun Kim (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School) ;
  • Sung-Pil Joo (Department of Neurosurgery, Chonnam National University Hospital, Chonnam National University Medical School)
  • Received : 2024.05.08
  • Accepted : 2024.08.13
  • Published : 2024.09.01
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Abstract

Objective : Advancements in AVM surgical techniques for cerebral arteriovenous malformation (AVM) underscore its efficacy. Our research aims to showcase the positive outcomes of treating low-grade AVMs surgically, focusing on safety and effectiveness. Methods : We retrospectively reviewed 55 patients (36 males and 19 females; average age 37.4 years) with Spetzler-Martin (S-M) grade 1 and 2 AVMs who underwent surgical resection between January 2009 and December 2022. Results : In our study, 55 patients with S-M grade 1 and 2 AVMs underwent surgical resection, evenly divided between grades 1 (50.9%) and 2 (49.1%). Intracranial hemorrhage was the primary symptom in 74.5% of cases. Pre-operative Glasgow coma scale (GCS) scores revealed 69.1% of patients scored above 13, with 18% below 8. Successful resection was achieved in 87.3%. Postoperatively, 95.5% of ruptured and 90.9% of unruptured AVM patients showed lower or same modified Rankin scale scores. Poorer outcomes were significantly linked to lower GCS scores and intranidal/flow-related aneurysms through multivariate logistic regression. Postoperative seizures noted in nine patients, were exclusive to the ruptured AVM group. Conclusion : Our findings indicate surgical resection as a beneficial treatment for low-grade AVMs, yielding high cure rates and positive functional outcomes in both ruptured and unruptured cases. Preoperative GCS scores and the presence of associated aneurysms are predictive of postoperative functional status. Additionally, managing postoperative seizures effectively is key to enhancing prognosis.

Keywords

Acknowledgement

This study was supported by a grant (BCRI24072) from the Chonnam National University Hospital Biomedical Research Institute.

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